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Metabolic score--a simple risk marker in non-ST elevation acute coronary syndromes.
Rev Port Cardiol. 2006 Feb; 25(2):155-71.RP

Abstract

BACKGROUND

Atherothrombotic coronary artery disease is increasingly recognized as part of a systemic metabolic disorder. However, little is known about the significance of metabolic dysfunction in the setting of acute coronary syndrome.

OBJECTIVE

Our aim was to assess the prognostic implications of markers of metabolic dysfunction at hospital admission obesity (BMI > 30), previous history of hypertension, admission glucose > 128 mg/dl, triglycerides > 150 mg/dl, and HDL cholesterol < 40 mg/dl for men, or < 50 mg for women--in patients with non-ST elevation acute coronary syndromes (ACS).

METHODS

A total of 303 consecutive patients admitted to the CCU with ACS were included in the study. Mean age was 63 +/- 10 years, and 86% were male. The primary end-point was a composite of death or non-fatal acute myocardial infarction (MI) at one-year follow-up. Each marker was assigned one point, and a metabolic score (MetScore) was calculated for each individual patient by adding together the number of markers present at hospital admission. Three groups were considered: group 1 (MetScore 0) with 0 markers (n = 30); group 2 (MetScore 1 to 3) with 1 to 3 markers (n = 222); and group 3 (MetScore 4 to 5) with 4 to 5 markers (n = 51).

RESULTS

The cumulative incidence of death or MI was 14.5%. We found a statistically significant relation between MetScore and outcome at one-year follow-up. The event rate was 3.3% in the MetScore 0 group, 13.9% in the MetScore 1 to 3 group and 23.5% in the MetScore 4 to 5 group (p = 0.0114). MetScore was an independent predictor of death or MI at one year, with a 2.3-fold risk increase (95% CI: 1.32-4.01; p = 0.003) from one group to the next. Other variables identified as independent predictors of outcome were advanced age, Killip class, ST-segment depression and previous CABG. The incidence of the primary end-point in diabetic patients without significant metabolic dysfunction and non-diabetic patients with SMD was similar (21.2% vs. 22.7%; p = NS).

CONCLUSION

Assessment of markers of metabolic dysfunction on admission in patients with non-ST elevation acute coronary syndromes, adds important prognostic information to conventional clinical, ECG and risk stratification markers and could prove useful in establishing secondary prevention strategies.

Authors+Show Affiliations

Serviço de Cardiologia, Hospital de Santa Cruz, Carnaxide, Portugal. lforl@clix.ptNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng por

PubMed ID

16673646

Citation

Raposo, Luís, et al. "Metabolic Score--a Simple Risk Marker in non-ST Elevation Acute Coronary Syndromes." Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology, vol. 25, no. 2, 2006, pp. 155-71.
Raposo L, Ferreira J, Aguiar C, et al. Metabolic score--a simple risk marker in non-ST elevation acute coronary syndromes. Rev Port Cardiol. 2006;25(2):155-71.
Raposo, L., Ferreira, J., Aguiar, C., Gonçalves, P. d. e. . A., Couto, R., & Seabra Gomes, R. (2006). Metabolic score--a simple risk marker in non-ST elevation acute coronary syndromes. Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology, 25(2), 155-71.
Raposo L, et al. Metabolic Score--a Simple Risk Marker in non-ST Elevation Acute Coronary Syndromes. Rev Port Cardiol. 2006;25(2):155-71. PubMed PMID: 16673646.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolic score--a simple risk marker in non-ST elevation acute coronary syndromes. AU - Raposo,Luís, AU - Ferreira,Jorge, AU - Aguiar,Carlos, AU - Gonçalves,Pedro de Araújo, AU - Couto,Rute, AU - Seabra Gomes,Ricardo, PY - 2006/5/6/pubmed PY - 2006/7/26/medline PY - 2006/5/6/entrez SP - 155 EP - 71 JF - Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology JO - Rev Port Cardiol VL - 25 IS - 2 N2 - BACKGROUND: Atherothrombotic coronary artery disease is increasingly recognized as part of a systemic metabolic disorder. However, little is known about the significance of metabolic dysfunction in the setting of acute coronary syndrome. OBJECTIVE: Our aim was to assess the prognostic implications of markers of metabolic dysfunction at hospital admission obesity (BMI > 30), previous history of hypertension, admission glucose > 128 mg/dl, triglycerides > 150 mg/dl, and HDL cholesterol < 40 mg/dl for men, or < 50 mg for women--in patients with non-ST elevation acute coronary syndromes (ACS). METHODS: A total of 303 consecutive patients admitted to the CCU with ACS were included in the study. Mean age was 63 +/- 10 years, and 86% were male. The primary end-point was a composite of death or non-fatal acute myocardial infarction (MI) at one-year follow-up. Each marker was assigned one point, and a metabolic score (MetScore) was calculated for each individual patient by adding together the number of markers present at hospital admission. Three groups were considered: group 1 (MetScore 0) with 0 markers (n = 30); group 2 (MetScore 1 to 3) with 1 to 3 markers (n = 222); and group 3 (MetScore 4 to 5) with 4 to 5 markers (n = 51). RESULTS: The cumulative incidence of death or MI was 14.5%. We found a statistically significant relation between MetScore and outcome at one-year follow-up. The event rate was 3.3% in the MetScore 0 group, 13.9% in the MetScore 1 to 3 group and 23.5% in the MetScore 4 to 5 group (p = 0.0114). MetScore was an independent predictor of death or MI at one year, with a 2.3-fold risk increase (95% CI: 1.32-4.01; p = 0.003) from one group to the next. Other variables identified as independent predictors of outcome were advanced age, Killip class, ST-segment depression and previous CABG. The incidence of the primary end-point in diabetic patients without significant metabolic dysfunction and non-diabetic patients with SMD was similar (21.2% vs. 22.7%; p = NS). CONCLUSION: Assessment of markers of metabolic dysfunction on admission in patients with non-ST elevation acute coronary syndromes, adds important prognostic information to conventional clinical, ECG and risk stratification markers and could prove useful in establishing secondary prevention strategies. SN - 0870-2551 UR - https://www.unboundmedicine.com/medline/citation/16673646/Metabolic_score__a_simple_risk_marker_in_non_ST_elevation_acute_coronary_syndromes_ L2 - https://medlineplus.gov/heartattack.html DB - PRIME DP - Unbound Medicine ER -